The surgical management of orbital fractures: a case series
Purpose The purpose of this research was to evaluate the outcomes, specifically diplopia and enophthalmos, as well as the complications of surgical repair of orbital fractures using the transconjunctival surgical approach. Methods A cross-sectional descriptive study was conducted. Thirty patients who underwent surgical repair of an orbital fracture were included in this case series. All patients were operated using the transconjunctival surgical approach and in all cases the fracture was repaired with 0.4 mm nylon foil sheeting (Supramid). The preoperative and postoperative clinical findings of visual acuity, diplopia and enophthalmos were analyzed, and postoperative complications were noted. Results Twenty-five of 30 patients (83%) presented with diplopia preoperatively and two patients (7%) had persistent diplopia postoperatively. Enophthalmos of greater than 2mm was present in 16 of 30 patients (53%) preoperatively and five patients (17%) had persistent enophthalmos postoperatively. All patients with persistent postoperative diplopia and or enophthalmos underwent late surgical repair (mean 10.6 months). Ten patients (33%) in this series were repaired early, within three weeks of trauma, and had no diplopia or enophthalmos postoperatively. There were no cases of lower lid retraction or ectropion. There was one complication related to the nylon foil. Conclusion The transconjunctival surgical approach used to repair orbital fractures was associated with good functional outcomes and few complications. Early surgical repair of orbital blowout fractures and the use of nylon foil sheeting are supported by this case series.